Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Employer's First Report of Injury or Occupational Disease; Physician's Report on Impairment of Vision; and Employer's Supplementary Report of Accident or Occupational Illness Modified 26381 6595 11608 Form LS-202
Form LS-210
Total burden requested under this ICR: 26381 6595 11608  
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